Search Results (7,562)

Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with limited therapeutic options, a high mortality rate, and poor overall survival, necessitating the development of new therapeutic and diagnostic strategies. This study investigated the potential of plasma-derived small extracellular vesicles (sEVs) as a source of molecular biomarkers associated with the treatment response. Methods: Plasma samples were obtained from patients with locally advanced and borderline resectable PDAC at baseline and following neoadjuvant chemotherapy, either FOLFIRINOX (5-FU [fluorouracil], leucovorin, oxaliplatin, and irinotecan) or GEM-ABRAX ( gemcitabine plus nab-paclitaxel), followed by stereotactic body radiation therapy (SBRT). sEVs were isolated from plasma at baseline, after neoadjuvant chemotherapy, and following SBRT, and were characterized by nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), nano-flow cytometry, and real-time PCR (RT-PCR). Results: The isolated sEVs exhibited an average size of <200 nm, expressed canonical exosome markers (CD63 and CD9), and exhibited pancreatic cancer (PanC)-associated markers, including cholecystokinin A receptor (CCK-AR) and carbohydrate antigen 19-9 (CA19-9). The sEV cargo included several PanC-associated microRNAs (miRNAs). Notably, the expression profiles of these miRNAs demonstrated interpatient variability, though a subset of miRNAs showed statistically significant changes following treatment. Conclusions: These findings support the feasibility of sEV isolation and molecular profiling from patient plasma and warrant further investigation as a potential source of biomarkers in pancreatic cancer. Full article

Survivors of primary gastric lymphoma (PGL) face a significantly elevated and persistent risk of developing second primary malignancies (SPMs), with gastric adenocarcinoma representing the most frequent SPM and standardized incidence ratios reaching up to 16-fold above the general population. This excess risk persists for decades after initial treatment and is associated with increased cause-specific mortality compared to matched primary cancers. Among patients with PGL, approximately 5% develop gastric cancer (with two-thirds being metachronous), and nearly 15% harbor precancerous lesions including atrophic gastritis, intestinal metaplasia, and dysplasia. Beyond gastric malignancies, survivors also experience elevated rates of extra-gastric SPMs, particularly digestive system tumors (43%), respiratory cancers (21%), and urinary tract malignancies (13%). Key risk factors include treatment with immunochemotherapy or radiotherapy, advanced age, male sex, advanced stage at diagnosis, ulcerative-type lymphoma morphology, and persistent Helicobacter pylori (HP) infection. Patients receiving combined chemoradiotherapy demonstrate the highest SPM risk, particularly for gastric and pancreatic cancers. These findings underscore the critical importance of lifelong, risk-adapted surveillance strategies integrating both hematology and gastroenterology follow-up. Annual endoscopic surveillance is recommended for high-risk patients, with intervals adjusted according to lymphoma histology, HP status, and the presence of precancerous gastric lesions. Mandatory HP eradication with confirmation of response is essential for reducing gastric cancer risk. Future research priorities include prospective, standardized studies to better quantify SPM risk, validation of molecular and microbiological biomarkers for individualized risk stratification, and development of predictive models to enable personalized surveillance protocols and improve long-term outcomes in this vulnerable population. Full article

The global emergence of the avian influenza virus (AIV) H5N1 clade 2.3.4.4B since 2016 has caused substantial losses in wild bird and poultry populations, along with heightened risks of transmission to humans and other mammals. Vaccination of poultry has been a key strategy to curb the virus’s spread and mitigate its socioeconomic impact. This report describes an outbreak of high pathogenicity avian influenza virus (HPAIV) H5N1 clade 2.3.4.4B in a flock of 15,000 brown layer chickens (170 days old), all of which had received a four-dose vaccination regimen with H5N1/H5N8 commercial vaccines at 17, 50, 100, and 125 days of age. Despite this vaccination history, H5N1 infection was confirmed approximately seven weeks post-vaccination. H5N1 infection was confirmed by RT-qPCR, virus isolation, and full genome sequencing covering all eight gene segments, followed by phylogenetic and molecular analyses. Clinical signs included reduced feed intake, decreased egg production, and a cumulative mortality rate of 35% over 52 days. Hemagglutination inhibition (HI) testing with various H5 antigens revealed inconsistent antibody titers (geometric mean: 4.0 to 9.1 log2). Genetic analysis of the full-length HA and NA gene sequences further revealed strong similarity to contemporaneous H5N1 clade 2.3.4.4B strains circulating in Egypt, with multiple mutations in the HA head domain, particularly near immunogenic epitopes and receptor binding sites. These findings highlight the limitations of current vaccination strategies under conditions of antigenic mismatch and complex immunization schedules, emphasizing the need for improved vaccine matching and continuous molecular surveillance. To improve outbreak management in poultry, enhanced vaccination protocols, stringent biosecurity measures, and rigorous monitoring practices are critical. Full article

Background: Persistent lymph node metastases after neoadjuvant radiochemotherapy (RCT) for locally advanced rectal cancer indicate poor response to treatment. This study evaluated the long-term prognosis of patients with residual nodal disease following neoadjuvant RCT and total mesorectal excision (TME) in comparison with patients who underwent upfront TME without adjuvant radiotherapy. Methods: Consecutive patients with rectal adenocarcinoma and histopathologically confirmed lymph node metastases after TME were identified from the prospectively maintained database of the colorectal unit at Dresden-Friedrichstadt General Hospital. Patients with distant metastases, in-hospital mortality, or postoperative radiotherapy were excluded. The two groups were comprehensively compared regarding patient-, tumor-, and treatment-related characteristics. Cumulative local recurrence, time to recurrence, cancer-specific survival, and overall survival were analyzed using the Kaplan–Meier method. Results: Between 1996 and 2021, 155 eligible patients were identified, including 101 patients in the RCT group and 54 in the upfront surgery group. Baseline characteristics were largely comparable, except for a higher median age (70.5 vs. 64 years, p < 0.001) and a higher proportion of lymphovascular invasion (36.0% vs. 15.2%, p = 0.004) in the upfront surgery group. Ten-year local recurrence rates were similar between groups (21.0% [95% CI: 10.4–31.6] vs. 20.8% [95% CI: 8.5–33.1], p = 0.609). No significant differences were observed in time to recurrence or cancer-specific survival. Overall survival was lower in the upfront surgery group, most likely reflecting the substantially higher age of these patients. Conclusions: Despite more intensive treatment, patients with a persistent ypN-positive category have outcomes no better than untreated patients with node-positive disease after TME, indicating a biologically high-risk subgroup. Non-response is therefore a sign of a negative selection. These patients may lose the opportunity for optimal local tumor control during prolonged neoadjuvant treatment, underscoring the urgent need for reliable predictive markers to identify non-responders and guide individualized treatment strategies. Full article

Objective: Self-expanding (SE) transcatheter aortic prostheses (THV) have been associated with an increased risk of new permanent pacemaker implantation (PPMI), particularly with deeper implantations in the left ventricular outflow tract (LVOT) that result in more atrioventricular conduction system damage, leading to higher rates of post-procedural conduction disturbances (CDs) and subsequently more PPMIs. The cusp-overlap technique (COT) is designed to provide better visualisation of the LVOT during implantation, aiming to achieve a shallower implantation depth (ID) and potentially reduce both post-procedural CDs and PPMIs. This study seeks to compare the traditional three-cusp coplanar view technique (3CT) with the newer COT in patients undergoing transcatheter aortic valve replacement (TAVR). Methods: From March 2018 to April 2020, a total of 586 patients underwent TAVR at the university clinic in Kiel. Among them, 226 patients who received SE prostheses were included in the study. After applying exclusion criteria, a final cohort of 203 patients was analysed. Of these, 106 patients underwent TAVR using the COT, while 97 patients underwent TAVR using the 3CT. The primary endpoints of the study were the occurrence of new CD and PPMI within 30 days post-procedure. Secondary endpoints included various post-TAVR events as defined by the Valve Academic Research Consortium 3 (VARC-3) safety criteria. A specific focus was placed on assessing the risk of high valve implantation according to VARC-3 criteria, specifically paravalvular insufficiency, valve embolisation, and coronary occlusion. Statistical analysis was conducted to compare outcomes between the COT and 3CT groups. Results: Implantation depths were significantly lower in the COT group compared to the 3CT group, with ID values from the NCC and LCC being 2.7 mm (±1.5) and 2.8 mm (±1.5) for the COT, and 5.4 mm (±3) and 6.6 mm (±2.6) for the 3CT (p < 0.001 for both). The incidence of high-grade CD, particularly Atrioventricular Block (AVB) II and III, was significantly higher in the 3CT group (26.8%) compared to the COT group (13.2%) (p = 0.023). The overall 30-day PPMI rate was 18.2% (n = 37), with a significant difference between the COT and 3CT groups (12.2% vs. 24.7%, p = 0.021). The primary indication for PPMI was permanent high-grade AVB occurring during or after TAVR, accounting for 95% of cases. No cases of TAVR embolisation, acute coronary occlusion or related syndromes were observed within the first 30 days post-procedure. There were no significant differences in 30-day mortality or post-procedural paravalvular insufficiency between the groups. In multivariable logistic regression analysis, the COT remained independently associated with lower odds of new post-procedural CD after adjustment for prior right bundle branch block (RBBB), prior first-degree AVB, predilatation, valve size and coronary artery disease (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.24–0.82, p = 0.009). For 30-day PPMI, the cusp-overlap technique demonstrated a borderline association with lower adjusted odds (OR 0.46, 95% CI 0.20–1.02, p = 0.057), while prior RBBB was independently associated with increased PPMI risk (OR 3.54, 95% CI 1.22–10.28, p = 0.020). Conclusions: The COT was associated with shallower implantation depth and lower rates of new post-procedural CD after multivariable adjustment. The association with reduced 30-day PPMI remained directionally consistent but was borderline after adjustment. These findings support the potential value of COT as a procedural strategy to reduce conduction-related complications after TAVR with self-expanding prostheses. Full article

Background: Allogeneic hematopoietic stem cell transplantation (allo-HCT) is the only curative therapy for myelofibrosis (MF), but its use is limited by substantial transplant related morbidity and mortality, particularly in older or comorbid patients. Treosulfan has emerged as a less toxic alternative to busulfan, with potential advantages in myeloablative and reduced intensity conditioning. Methods: We conducted a comprehensive, multi-database literature search (PubMed, Scopus/EMBASE, Cochrane Library, Web of Science, and grey literature) for studies published between 2000 and 2025 evaluating treosulfan-based conditioning in MF patients undergoing allo-HCT. Data on patient characteristics, conditioning regimens, engraftment, graft-versus-host disease (GVHD), and survival outcomes were synthesized. Results: Eight studies including more than 800 patients were analyzed. Treosulfan was most commonly combined with fludarabine, with or without additional agents. Engraftment rates were consistently high at 94 to 100%, with low non-relapse mortality (NRM) and favorable progression-free survival (PFS). An EBMT registry study demonstrated superior survival and significantly lower NRM compared with busulfan based regimens. Benefits were observed across older patients, alternative donors, and second transplants. Higher treosulfan doses were associated with increased toxicity in some cohorts. Conclusions: Treosulfan based conditioning offers an effective and better tolerated option for MF transplantation. Prospective trials are needed to refine dosing and patient selection. Full article

Backgrounds/Objectives: Malignant pleural effusion (MPE) is a frequent complication of advanced cancer, and talc pleurodesis via video-assisted thoracoscopic surgery (VATS) represents a standard palliative treatment with high efficacy. However, evidence regarding synchronous bilateral pleurodesis in patients with bilateral MPE is limited. This study evaluates the feasibility, safety, and outcomes of a single-stage bilateral VATS talc pleurodesis approach. Materials and Methods: We retrospectively analyzed patients undergoing synchronous bilateral VATS talc poudrage between 2000 and 2025 at a single tertiary cancer center. Inclusion criteria included adult patients with bilateral MPE, expandable lungs, and suitability for surgery. Preoperative assessment involved imaging and multidisciplinary evaluation. Perioperative data, complications, mortality, and recurrence rates at 30 days and 3 months were collected. Survival and pleural effusion-free survival were estimated using the Kaplan–Meier method. Results: Thirty patients were included (median age 63.2 years). The most common primary tumors were breast (43%), lung (30%), and ovarian cancer (17%). Mean operative time was 78.6 min, with no intraoperative complications. Mean hospital stay was 6 days. Postoperative morbidity included atrial fibrillation (13%) and respiratory failure (6.6%), both managed conservatively. Thirty-day mortality was 3%. Pleural effusion recurrence occurred in 6.6% at 3 months and 10% at 7 months. Mean follow-up was 9.7 months. Conclusions: Synchronous bilateral VATS talc pleurodesis is a feasible and safe procedure in selected patients with bilateral MPE with acceptable morbidity. Further prospective studies are needed to confirm these findings and refine patient selection. Full article

Oral cancer is a significant public health concern and is among the most common malignant tumors of the head and neck. Its incidence and mortality rates remain persistently high, especially in regions where smoking and betel nut chewing are prevalent. Due to its high mortality rate, early detection is crucial for improving patient outcomes. However, early symptoms of oral cancer often resemble benign oral lesions, leading to delayed diagnosis. In this study, a vision transformer (ViT) model with Optuna (ViTOPT) is employed to perform classification tasks of identifying oral cancer images. The Optuna is used to determine hyperparameters in ViT. Histological images are obtained from a publicly available dataset. Three classification tasks with histological images namely classifying oral squamous cell carcinoma (OSCC) and leukoplakia (LEUK), classifying the presence of dysplasia, and classifying OSCC and leukoplakia with or without dysplasia are performed in this study. Numerical results reveal that the proposed ViTOPT framework is able to provide satisfactory performance in oral cancer recognition. Thus, the proposed ViTOPT model is a feasible and effective alternative in identifying oral cancer. Full article

Background and Objectives: Perforated peptic ulcer (PPU) is an emergent condition managed by surgical intervention. No conclusive evidence has been produced regarding the need for drain placement after primary repair. Our meta-analysis aimed to provide insight into the short-term outcomes by comparing the two strategies of drain omission or intra-operative placement of at least one drain. Materials and Methods: We performed a systematic review following the PRISMA guidelines. PubMed/MEDLINE, Web of Science, Cochrane Library, and Embase databases were utilized to identify articles of interest. Meta-analysis was performed using RevMan Version 5.4. Eligible studies were comparative studies (RCTs and observational studies) enrolling adult patients (≥18 years) undergoing emergency primary repair for PPU, with or without prophylactic intra-abdominal drain placement; case reports and series of fewer than 10 patients were excluded. The literature search covered January 2010 to 22 February 2026. Risk of bias was assessed using the Cochrane RoB 2.0 tool for RCTs, and the ROBINS-I V2 tool for observational studies; certainty of evidence was graded using the GRADE framework. Pooled effect estimates were calculated using a random-effects model and expressed as odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI); statistical heterogeneity was quantified using the I² statistic. Results: Five studies were considered for comparison, for a total of 1354 patients (744 and 610 in the drain and no-drain groups, respectively). Three were randomized controlled trials, and two were retrospective cohort studies, conducted across four countries (India, the USA, Egypt, and Japan). Meta-analysis of the pooled results showed that drain omission was associated with a shorter length of stay (LOS) (MD −2.13, 95% CI [−3.91–−0.35], p < 00001) and a lower rate of superficial surgical site infections (SSIs) (16.7% vs. 52.7%, OR 0.24, 95%CI [0.11–0.55], p = 0.0007). No difference was observed regarding the rate of leaks, reoperation, or deep SSIs. Low-certainty evidence suggested higher postoperative mortality in the no-drain group (OR: 1.96; 95% CI: 1.10 to 3.48; p = 0.02; I² = 0%), largely driven by retrospective studies with a high risk of bias. This mortality finding is of very low certainty and is most likely attributable to confounding in the observational studies rather than a true causal effect of drain omission. Several outcomes were based on data from only two to three studies, and the overall certainty of evidence was low to very low. Conclusions: Drain omission after primary repair for PPU may be associated with better outcomes in terms of LOS and superficial SSIs, primarily in lower-acuity patients, as reflected by the inclusion criteria of the contributing RCTs. Pooled analysis showed a higher postoperative mortality in the no-drain group; however, given the significant biases among included studies, our results should be interpreted as non-causal and thus require careful interpretation. Further research encompassing the full clinical spectrum of PPU is needed to confirm our results. Evidence certainty was low to very low across all outcomes, primarily due to a risk of bias, high heterogeneity (I² up to 95% for LOS), indirectness, and imprecision. Full article

Chronic kidney disease (CKD) affects more than 10% of the world’s population, increasing the risk of cardiovascular disease and mortality. Background: Nephroprotective interventions can reduce the risk of end-stage renal disease, delay the time to dialysis, and prolong life. However, there is ongoing debate about the effectiveness of combining amino acid ketoanalogues (KAA) with a low-protein diet (LPD) to slow CKD progression. This study aimed to retrospectively analyze kidney function outcomes after a 6-month KAA+LPD regimen in patients with CKD. Methods: The analysis included results from 38 non-dialyzed patients (12 F, 26 M; age 64.0 ± 13.6 years) with stable CKD in stages G4 to G5, who followed LPD with KAA (Ketosteril, Fresenius Kabi) treatment as part of the Polish National Health Fund Ketosteril Drug Program. Results: No significant change in estimated glomerular filtration rate (eGFR) was observed during 6 months of KAA+LPD therapy. However, eGFR increased or decreased in half of the patients (p < 0.001), and this change was associated only with initial protein intake and urinary phosphate excretion. Initial high phosphate excretion was independently associated with an increase in eGFR, and initial phosphaturia > 0.5 g/24 h identified eGFR improvement (sensitivity 84.2%; specificity 57.9%; AUC 0.712; p = 0.018) in CKD patients who started KAA+LPD treatment. Conclusions: Six-month treatment with KAA+LPD may be associated with stabilization of kidney function in patients with CKD stages G4-G5. The individual effect of KAA+LPD on renal function may be related to the initial protein intake level and urinary phosphate excretion. Further studies are needed to validate these findings across larger patient populations with a broader spectrum of symptoms. Full article

Background: Out-of-hospital cardiac arrest is a major cause of mortality, and survival depends heavily on rapid defibrillation. Automated external defibrillators (AEDs) can significantly improve outcomes when used before emergency medical services (EMS) arrive, yet access to and use of these devices remain uneven across communities. This study investigates racial and geographic disparities in AED use during EMS encounters in the United States, evaluating differences across racial groups, geographic settings, cardiac arrest status, and patient acuity, irrespective of whether a bystander or EMS personnel applied the device. Methods: This descriptive study used aggregated data from the National Emergency Medical Services Information System (NEMSIS) Public Release Data Cube to compare AED use across racial, geographic, cardiac arrest, and acuity categories. AED use was defined as any documented application during the EMS encounter. Results: The dataset included 106,246 EMS encounters across six racial and ethnic groups. AEDs were applied in 16,688 encounters (15.7%), with substantial variation across demographic and geographic categories. Asian, American Indian or Alaska Native, and Black or African American patients had the highest rates of AED use, while White patients had the lowest rate despite representing the largest share of encounters. Urban areas accounted for most AED deployments, whereas suburban and frontier regions showed markedly lower use, while rural AED use was similar to urban rates. AED application was strongly associated with cardiac arrest and high patient acuity, yet racial differences persisted even within these clinically severe categories. Conclusions: AED use generally aligns with clinical indicators such as cardiac arrest and critical acuity, but meaningful racial and geographic differences were observed, reflecting descriptive patterns rather than confirmed disparities. These patterns should be interpreted cautiously, as the aggregated nature of the dataset limits the ability to determine whether differences reflect inequities, incident characteristics, or EMS system factors. These findings highlight the need for targeted strategies to expand AED access, improve device placement, and strengthen community readiness in underserved areas. Integrating AED availability into broader EMS planning and community outreach may help reduce inequities and create conditions that support improved survival outcomes. Further research using individual-level data and geospatial methods is needed to clarify the drivers of these observed differences and inform equitable prehospital care policies. Full article

Japanese flounder (Paralichthys olivaceus) is an economically important species in China’s marine fishery industry. However, due to long-term intensive fishing, its wild population has declined sharply. Artificial stock enhancement has become a core measure for restoring its resources. This study aimed to investigate the effects of different immersion durations and concentrations of SrCl₂ solution (10, 20, 40, 80 mg/L) on strontium (Sr) deposition in the otoliths of P. olivaceus, and to systematically evaluate the impacts of Sr marking on the fish’s antioxidant capacity and digestive enzyme activity. The results showed that the otolith Sr/Ca ratio was positively correlated with marking concentration and duration; the optimal parameters were 40 mg/L for 4 days, with the Sr/Ca ratio returning to baseline after 30 days post-marking, and a 100% marking success rate. There were no significant differences in body length, body weight, or condition factor between the experimental groups and the control group (p > 0.05), but mortality was significantly increased in the 80 mg/L group. Digestive enzymes exhibited a dose-dependent response to Sr exposure, characterized by activation at low concentrations and inhibition at high concentrations; lipase was the most sensitive, with an inhibition threshold of 10 mg/L. Sr marking within the range of 20–40 mg/L for 4–8 days significantly activated the activity of T-AOC, CAT, GPx, and SOD (p < 0.05) and reduced MDA content, indicating that the antioxidant system was activated without causing persistent oxidative damage. In conclusion, Sr marking is a safe and efficient method for otolith marking in Paralichthys olivaceus. The recommended protocol is immersion in a 40 mg/L SrCl₂ solution for 4 days, followed by a 30-day recovery period in clean seawater before being used for stock enhancement evaluation. This study provides a scientific basis and technical support for assessing the effectiveness of stock enhancement in P. olivaceus. Full article

Background/Objectives: Chronic limb-threatening ischemia (CLTI) is the most advanced stage of peripheral arterial disease and is associated with high rates of major amputation and mortality. The angiosome concept has become an important tool for planning targeted revascularization. However, its clinical value may be limited in patients with complex arterial disease, impaired collateral circulation, and microvascular dysfunction. This review explores the relationship between angiosome-guided revascularization and the emerging woundosome concept, which focuses on functional wound perfusion. Methods: A narrative review with a structured literature search was performed using PubMed/MEDLINE, Scopus, and Web of Science. Studies evaluating angiosome-guided revascularization, direct versus indirect revascularization, collateral circulation, pedal arch integrity, and perfusion-related outcomes in CLTI and diabetic foot disease were included. Results: Most observational studies and meta-analyses suggest that direct angiosome-targeted revascularization may improve wound healing and limb salvage in selected patients. However, clinical outcomes are also influenced by collateral circulation, anatomical variability, infra-malleolar perfusion, pedal arch integrity, and microvascular function. The woundosome concept expands the traditional angiosome model by emphasizing effective perfusion of the wound bed through direct arterial inflow, collateral pathways, and functional perfusion assessment. Conclusions: Combining the angiosome and woundosome concepts may provide a more practical and individualized approach to revascularization planning in CLTI by integrating anatomical vascular mapping with functional wound perfusion assessment. Full article

Obstructive sleep apnea (OSA) is a highly prevalent yet frequently underdiagnosed condition that is associated with significant cardiopulmonary, metabolic, and neurocognitive outcomes. Risk factors for OSA overlap with illnesses commonly observed in intensive care unit (ICU) patients, resulting in a disproportionately elevated burden on healthcare. This structured narrative review synthesizes current evidence regarding the prevalence, diagnostic challenges, and clinical implications of obstructive sleep apnea (OSA) in critically ill adults admitted to intensive care units (ICUs) using PubMed, EMBASE, and Scopus. Key search terms included “obstructive sleep apnea,” “ICU,” and “critical illness.” Results showed that OSA is present in up to 60–70% of ICU patients, yet only ~5% are formally diagnosed during hospitalization. Underdiagnosis is linked to prolonged mechanical ventilation, extubation failure rates as high as 30%, 2-fold higher perioperative complication rates, cardiovascular instability, 1.8-fold greater 30-day ICU readmission rates, and 2.2-fold mortality. Standard screening tools have limited applicability in ICU patients. Emerging alternatives, such as overnight oximetry, polygraphy, and machine learning models lack validation. Our analyses reveal that current diagnostic and treatment strategies are poorly adapted to critically ill patients. Integration of OSA as a part of ICU management, diagnosis, and intervention may reduce readmissions and mortality. Full article

Yak diarrhea is a major health concern in high-altitude regions, yet data are lacking in Ganzi Tibetan Autonomous Prefecture, a key yak-producing area in China. This study aimed to describe the prevalence, mortality, seasonal patterns, and pathogen profiles of yak diarrhea in Ganzi Prefecture. Between 2017 and 2024, surveys were conducted across 5 counties, involving 5 cooperatives and 62 households. Fecal and blood samples were collected from healthy (n = 1805) and diarrheic yaks (n = 189) for pathogen detection. Among 1.9066 million yaks, breeding females accounted for 48.48% and calves 26.32%. Diarrhea prevalence was 12.22% in adult yaks and 20.91% in calves, with mortality rates of 15.71% and 28.29%, respectively. Cases peaked in spring and winter. Pathogen detection in healthy yaks revealed intestinal parasites (43.26%) and BVDV (2.33%). In diarrheic yaks, higher rates were observed for intestinal parasites (46.56%), E. coli (10.05%), Salmonella (10.58%), BVDV (22.75%), and Theileria (25.40%). Mixed infections were common. These findings provide a descriptive baseline for guiding region-specific control strategies. Full article